Reports of Practical Oncology and Radiotherapy

Reports of Practical Oncology and Radiotherapy

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Volume 9, Number 6, 2004

Malignant neoplasms of parameningeal region in children - report from two paediatric centres of oncology

Summary:

Subject: To present the analisis of initial clinical symptoms and difficulties in establishing proper diagnosis.
Material and methods: Data on 32 patients with the diagnosis of parameningeal malignant neoplasms were subjected to a retrospective analysis. The study group consisted of 9 girls and 23 boys, at the age of 2-17. The analysis involved clinical symptoms prior to diagnosis, the response to treatment, possible necessary modifications of therapeutic schemes and treatment outcome in particular histological types of parameningeal malignant neoplasms.
Results: The length of history taking in the whole group ranged from 2 weeks to 24 months. The dominant symptoms were directly associated with the local growth of the tumour and its spread to the regional lymph nodes. The extent of spread of the neoplasm in children with STS was found to be: III° in 14 and IV° in 3 patients. All the children with NHL-B were originally assigned to group B according to LMB and the patients with lymphoepithelioma to III° (2 children) and IVA° (4 children) according to TNM and AJCC. Among the patients with parameningeal malignant neoplasms, 21/32 children demonstrated CR after the complete treatment, including 8/17 with STS and all patients with NHL-B, 4/6 with lymphoepithelioma. Seven patients died: 5 with STS and 2 with lymphoepithelioma. The prognosis of four patients undergoing treatment for STS recurrences is uncertain.
Conclusions: Non-characteristic initial clinical symptoms and signs of parameningeal tumours, often suggestive of an inflammatory process, results in diagnostic difficulties. Since radical resection of parameningeal neoplasms in children is impossible, the prognosis depends on the neoplasm's sensitivity to chemo- and radiotherapy.